Why didn't paramedics take Joel Marino to St. Mary's?

The Level One Trauma Center at the University of Wisconsin Hospital and Clinics

When Joel Marino was found, barely alive, in an alley off Park Street, he was only a block from St. Mary's Hospital. Police have speculated that Marino was stabbed in his home on West Shore Drive and had been staggering toward St. Mary's, looking for help.

Why then, when Marino was found so close to St. Mary's, did paramedics take him to UW Hospital, a few miles away?

Lori Wirth, spokeswoman for the Madison Fire Department, says Marino, who died later at the hospital, was judged by paramedics to have "Level I" trauma -- wounds so severe he would likely need the help of a specialist.

"Our protocol is to take them to the city's only Level I Trauma Center, which is UW Hospital," she says. "Even though the distance is longer, the important part is that UW Hospital has all the specialties available all the time."

Level I trauma centers are staffed round the clock with specialists. "You don't just have a heart surgeon on staff, you have someone who knows kidneys," says Wirth. "So everyone is ready to go when a trauma patient comes in."

While she doesn't know what kind of medical attention Marino might have needed, Wirth notes that if he'd gone to St. Mary's, the hospital might have had to call in a doctor. Or Marino might have been transferred to UW Hospital anyway.

Wirth won't speculate on whether the extra few minutes to transport Marino from the alley to UW made a difference. The city's paramedics "can do a lot in transit to keep the patient stable," she says, adding that most of the city's severe traumas go to UW. "It sounds like they made the right call."